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SYSTEM RECORD OF COMPLETION <br /> This form is to be completed by the system installation contractor at the time of system acceptance and approval. <br /> It shall be permitted to modify this form as needed to provide a more complete and/or clear record. <br /> Insert N/A in all unused lines. <br /> Attach additional sheets,data,or calculations as necessary to provide a complete record. <br /> Form Completion Date: 6/20/2023 Supplemental Pages Attached: <br /> 1. PROPERTY INFORMATION <br /> Name of property: ROCKEFELLER SQUARE 2 <br /> Address: 2611 ROCKEFELLER AVE EVERETT,WA 98201 <br /> Description of property: APARTMENT BUILDING <br /> Name of property representative: JEREMY MORGAN <br /> Address: <br /> Phone: 360-391-8751 Fax: E-mail: <br /> 2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION <br /> Installation contractor: FIRE PROTECTION,INC. <br /> Address: 17410 ASH WAY,Ste 8, LYNNWOOD,WA 98037 <br /> Phone: 425.290.9600 Fax: E-mail: DAVID@FPISEATTLE.COM <br /> Service organization: FIRE PROTECTION, INC. <br /> Address: 17410 ASH WAY,Ste 8, LYNNWOOD,WA 98037 <br /> Phone: 425.290.9600 Fax: E-mail: DAVID@FPISEATTLE.COM <br /> Testing organization: FIRE PROTECTION, INC. <br /> Address: 17410 ASH WAY,Ste 8, LYNNWOOD,WA 98037 <br /> Phone: 425.290.9600 Fax: E-mail: DAVID@FPISEATTLE.COM <br /> Effective date for test and inspection contract: <br /> Monitoring organization: SECURITAS TECHNOLOGY/ALARM CENTER, INC <br /> Address: 4500 31'Ave SE, LACEY,WA 98503 <br /> Phone: 800.752.2490 Fax: 360.438.4245 E-mail: OnTest@sbinc.com <br /> Account number: LAC88-3609 Phone line 1: Phone line 2: <br /> Means of transmission: CELLULAR <br /> Entity to which alarms are retransmitted: MONITORING STATION Phone: <br /> 3. DOCUMENTATION <br /> On-site location of the required record documents and site-specific software: DOCUMENT CAN <br /> 4. DESCRIPTION OF SYSTEM OR SERVICE <br /> This is a: ®New system ❑ Modification to existing system Permit number: <br /> NFPA 72 edition: 2016 <br /> 4.1 Control Unit <br /> Manufacturer: GAMEWELL Model number: 7075 <br /> 4.2 Software and Firmware <br /> Firmware revision number: 6.05.03 <br /> 4.3 Alarm Verification ® This system does not incorporate alarm verification. <br /> Number of devices subject to alarm verification: Alarm verification set for seconds <br /> Copyright®2012 National Fire Protection Association.This form may be copied for individual use other than for resale.it may not be copied for commercial sale or distribution. <br /> h_. 1 :�T s <br />